Current status of obamacare.

#76
#76
Chattaben said:
"The best minds are not in government." -- Ronald Reagan. He proved that without a doubt.
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Nevertheless, Ronnie was ten times better than dimwit incompetant Jimmy 'Peanutbrain' Carter.

Carter isn't just a dumbass, he's a sorry excuse for a human being.

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Even Fidel Castro isn't as sorry a pos as Jimmy Carter.

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#77
#77
In 301 AD, the Roman emperor Diocletian imposed price controls on most commodities and professions in the empire. The penalty for raising prices was death. Yet the controls failed utterly, leading to shortages, more inflation and the near collapse of the imperial economy.

Now, nearly two millennia later, President Obama seems determined to demonstrate how little we've learned.

Yesterday, the president proposed giving the federal government the power to regulate insurance premiums.
 
#78
#78
KB5252 said:
Absolutely, the only problem I have with this statement coming from you as an Obama supporter is that Obama's plan would have accomplished neither of these objectives. Government, particularly our government, is incapable of running any endeavor efficiently and effectively. Their track record proves as much, why should we keep entrusting them when they have proven time and again they're unworthy?
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I think that is a fair point to be made here and certainly a consideration in how to move forward. But I weigh that problem against the absolute, 100 % certainty, that the current regime of health insurance is doomed to fail.

It is not sustainable. No one can credibly argue otherwise.

And when I say not sustinable, I'm not talking 100 years. I'm talking 10 or so before it collapses or bankrupts the country.






droski said:
so basically anyone healthy with money will be subsidizing the rest of the country. seems fair.
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See, what you do not seem to appreciate is that the current system does EXACTLY that. Those of us working and for whom a portion of what would be comepsnation to us (or investors) is paying for insurance. Which is higher than it should be because many people who are uninsured get very inefficient care, resulting in higher premiums ot those of us buying it.

But as costs go higher, and as the pool of premium payers gets smaller and smaller and seeks to shift the cost to the bigger payers, the cost to the payers goes up and up and up.

Our system and politicians do not have the political will to say, "That's enough. If you do not have health insurance and can't pay the bill, we are going to let you die."






droski said:
why shouldn't people at higher risk pay more?
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Arguably, yes. But that assumes we can effectively identify them. And we can to some degree, but not with much precision other than to say that overwiehgt people are more likely to have general problems or people with certain genetic traits are more likely to have specific problems.
 
#79
#79
lawgator1 said:
I think that is a fair point to be made here and certainly a consideration in how to move forward. But I weigh that problem against the absolute, 100 % certainty, that the current regime of health insurance is doomed to fail.
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Here's a ponderable then:

Since the current system is doomed, is it better to replace it with a system that doesn't address the core reason it is doomed (costs) but only adds more people to the insurance pool (many of whom will bring high needs) and changes a few insurance regs that will put upward pressure on prices?

or

Start on a new plan with sustainable cost control as the center piece?

Here's why Obamacare is worse - it does nothing to solve the core problem but it will be in place for years/decades before Washington tries to tackle it again.

Do it right or make small changes and move on to the next attempt to fix things. Either is vastly better than the BS approach that is being pushed.
 
#80
#80
lawgator1 said:
See, what you do not seem to appreciate is that the current system does EXACTLY that. Those of us working and for whom a portion of what would be comepsnation to us (or investors) is paying for insurance. Which is higher than it should be because many people who are uninsured get very inefficient care, resulting in higher premiums ot those of us buying it.
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And a government run system does similar. Those actually paying taxes are the ones subsidizing healthcare for the rest. You are trading the same process from the private sector to the public sector - just changing the person handling the money. Obama's system wants the higher income earners to pay for the lower income earners who have no insurance. You do realize that is what is happening now right? Same method just in the hands of the government rather than multiple competing insurance providers.
 
#81
#81
lawgator1 said:
I think that is a fair point to be made here and certainly a consideration in how to move forward. But I weigh that problem against the absolute, 100 % certainty, that the current regime of health insurance is doomed to fail.

It is not sustainable. No one can credibly argue otherwise.

And when I say not sustinable, I'm not talking 100 years. I'm talking 10 or so before it collapses or bankrupts the country.






I agree, the problem here is that Obama's plan would be doomed to fail as well, all it would do is give us a new structure and buy us a little more time at a very high cost, just as high if not more than we see right now.

Why waste the time we do have proposing a bad plan when we could use it to come up with a solution that wouldn't wreck us and have to be addressed in the near future again?



See, what you do not seem to appreciate is that the current system does EXACTLY that. Those of us working and for whom a portion of what would be comepsnation to us (or investors) is paying for insurance. Which is higher than it should be because many people who are uninsured get very inefficient care, resulting in higher premiums ot those of us buying it.

But as costs go higher, and as the pool of premium payers gets smaller and smaller and seeks to shift the cost to the bigger payers, the cost to the payers goes up and up and up.

Our system and politicians do not have the political will to say, "That's enough. If you do not have health insurance and can't pay the bill, we are going to let you die."









Arguably, yes. But that assumes we can effectively identify them. And we can to some degree, but not with much precision other than to say that overwiehgt people are more likely to have general problems or people with certain genetic traits are more likely to have specific problems.
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See underlined response to bold.
 
#82
#82
volinbham said:
Here's a ponderable then:

Since the current system is doomed, is it better to replace it with a system that doesn't address the core reason it is doomed (costs) but only adds more people to the insurance pool (many of whom will bring high needs) and changes a few insurance regs that will put upward pressure on prices?

or

Start on a new plan with sustainable cost control as the center piece?

Here's why Obamacare is worse - it does nothing to solve the core problem but it will be in place for years/decades before Washington tries to tackle it again.

Do it right or make small changes and move on to the next attempt to fix things. Either is vastly better than the BS approach that is being pushed.
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Certainly a significant part of the cost increase of health insurance is the raw cost of the care itself. Technology and pharmaceuticals are moving so fast, which is great, but at extreme cost, which is problematic.

At the same time, it would be foolish not to recognize that the other part of the equation leading to high premiums is the business cost of the process represented by the privatization of health insurance.

Obama would reduce or eliminate the latter over a significant period of time.

What, exactly, would you do?

And, with regard to your two part point above, you obviously favor the "Start on a new plan with sustainable cost control as the center piece" notion.

How would you go about doing that? What can the government do to engage that without eliminating the insurance companies in some other manner?

Regulate premiums? Regulate costs of care?

Seriously, if a public option is not the best, or at least only viable, way to stabilize and control cost increases, what is?
 
#83
#83
True health reform won't happen until we get back to what insurance is doing what it is meant to do: cover catastrophic events no normal person could be able to afford. My car insurance does not cover my oil changes, tire rotations, or routine repairs. This current mandated health insurance plan (which was McCains direction btw) will only cause health insurance companies to collapse because it will get to the point that most healthy people will pay the cheaper tax vs. getting coverage. Once that happens the "only option" at that point will be single payer.

Ya it will sting for a while but once the consumer is back into the picture (as BPV keeps pointing to) then things will normalize again. This my fear of the current climate. We have a bunch of well meaning people saying the right things... but when it comes right down to it how much are people willing to sacrifice? Like the tea parties (which I do like) alot of the people are rightfully angry at the out of control spending, but I truly wonder how many of them will admit that their cake eating is part of the problem.
 
#84
#84
lawgator1 said:
Certainly a significant part of the cost increase of health insurance is the raw cost of the care itself. Technology and pharmaceuticals are moving so fast, which is great, but at extreme cost, which is problematic.

At the same time, it would be foolish not to recognize that the other part of the equation leading to high premiums is the business cost of the process represented by the privatization of health insurance.

Obama would reduce or eliminate the latter over a significant period of time.

What, exactly, would you do?

And, with regard to your two part point above, you obviously favor the "Start on a new plan with sustainable cost control as the center piece" notion.

How would you go about doing that? What can the government do to engage that without eliminating the insurance companies in some other manner?

Regulate premiums? Regulate costs of care?

Seriously, if a public option is not the best, or at least only viable, way to stabilize and control cost increases, what is?
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Obama has abandoned the public option so it does not address the issue with privatization.

I would attack costs via tort reform, reducing state mandates (tricky) to true minimums of essential care (e.g. no requiring fertility treatments, etc), open competition and allow the offering of bare bones plans all the way up to caddy plans. WRT insurance reform I'd adopt some of the restrictions on insurance abuses but by allowing "a plan for every need" that can compete nationally we wouldn't force upward pressure on insurance costs since not all insured would need the same high minimum coverage.

For the uninsured, they could either purchase the minimal plans that offer catastrophic coverage or we could subsidize the purchase for the very poor.

Overall, the idea is to reconnect patients with the costs of care so they can make decisions. We ease restrictions on what type of plans can be sold so low costs, bare bones plans can be bought by those that want them and folks who want more can pay for it. I'm not opposed to removing the tax deduction for premiums at the high end.
 
#85
#85
volinbham said:
Obama has abandoned the public option so it does not address the issue with privatization.

I would attack costs via tort reform, reducing state mandates (tricky) to true minimums of essential care (e.g. no requiring fertility treatments, etc), open competition and allow the offering of bare bones plans all the way up to caddy plans. WRT insurance reform I'd adopt some of the restrictions on insurance abuses but by allowing "a plan for every need" that can compete nationally we wouldn't force upward pressure on insurance costs since not all insured would need the same high minimum coverage.

For the uninsured, they could either purchase the minimal plans that offer catastrophic coverage or we could subsidize the purchase for the very poor.

Overall, the idea is to reconnect patients with the costs of care so they can make decisions. We ease restrictions on what type of plans can be sold so low costs, bare bones plans can be bought by those that want them and folks who want more can pay for it. I'm not opposed to removing the tax deduction for premiums at the high end.
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+1

:hi:

I mean honestly, the only reasons LG wants this filth is because he wants the taxpayer to pick up his bill at his firm.
 
#86
#86
volinbham said:
Obama has abandoned the public option so it does not address the issue with privatization.

I would attack costs via tort reform, reducing state mandates (tricky) to true minimums of essential care (e.g. no requiring fertility treatments, etc), open competition and allow the offering of bare bones plans all the way up to caddy plans. WRT insurance reform I'd adopt some of the restrictions on insurance abuses but by allowing "a plan for every need" that can compete nationally we wouldn't force upward pressure on insurance costs since not all insured would need the same high minimum coverage.

For the uninsured, they could either purchase the minimal plans that offer catastrophic coverage or we could subsidize the purchase for the very poor.

Overall, the idea is to reconnect patients with the costs of care so they can make decisions. We ease restrictions on what type of plans can be sold so low costs, bare bones plans can be bought by those that want them and folks who want more can pay for it. I'm not opposed to removing the tax deduction for premiums at the high end.
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Agree 100%. The third-party payer problem essentially can be boiled down to the fact that where another party is footing the bill, the consumer acts without to regard to costs - on both him an society. Because of this, the use of insurance to pay for non-catastrophic coverage results in over consumption, lack of competition, and a disregard for cost of care related to the benefits to be received (i.e., people have no problem paying for exams using cutting edge technology even though the benefit may be marginal compared to a vast increase in cost). For this problem, among things like tax credits for HSAs, I would also suggest taxing healthcare plans to the extent they pay for individual healthcare below a certain portion of the consumer's income - this can be done at the individual or company level. The result will be that healthcare insurance that covers all of the basics will increase in price, essentially taking into account the costs on society of overuse (the moral hazard). As all-inclusive plans increase, people will naturally choose less inclusive plans, become more connected with their own care by paying out of pocket, and ultimately return healthcare to a normal functioning market.
 
#89
#89
"I did not sign away my right to get the best possible health care for myself when I entered politics."

I'm confused. I thought canada HAD the best possible health care?
 
#90
#90
droski said:
"I did not sign away my right to get the best possible health care for myself when I entered politics."

I'm confused. I thought canada HAD the best possible health care?
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I get so tired of hearing that ....as well as all the people that point to life expectancies as somehow infallible proof that America is behind most OECD countries in terms of healthcare. See Life Expectancies Adjusted to Take Out Homicides
 
#93
#93
volinbham said:
Obama has abandoned the public option so it does not address the issue with privatization.

I would attack costs via tort reform, reducing state mandates (tricky) to true minimums of essential care (e.g. no requiring fertility treatments, etc), open competition and allow the offering of bare bones plans all the way up to caddy plans. WRT insurance reform I'd adopt some of the restrictions on insurance abuses but by allowing "a plan for every need" that can compete nationally we wouldn't force upward pressure on insurance costs since not all insured would need the same high minimum coverage.

For the uninsured, they could either purchase the minimal plans that offer catastrophic coverage or we could subsidize the purchase for the very poor.

Overall, the idea is to reconnect patients with the costs of care so they can make decisions. We ease restrictions on what type of plans can be sold so low costs, bare bones plans can be bought by those that want them and folks who want more can pay for it. I'm not opposed to removing the tax deduction for premiums at the high end.
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Tort reform is fine with me, but its really not nearly as significant a part of the cost of care as advertised by the business lobby.

Mandated benefits would have some impact, but not as much as you might think. The ones that seem truly trivial are the least expensive.

The poor cannot afford catastrophic care. And they wouldn't buy it anyway. If they don't, and get ill, what do you say to them? No care?

See, that's the problem. If all have access to care but only some pay for it, then those paying dwindle in number, by dropping out directly or by cost shifting their premiums to us.

We pay for it, one way or another. You have to enforce noncoverage decisions and no one is politically up to the task.
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#94
#94
Why don't we have Obamacare for lawyers. Lets limit what they can charge and place standards over them where they have to serve anyone that comes into see them. Let lawers be government funded just like the doctors. If we do it one group, then why not another?
 
#95
#95
Ask your GP about tort reform as meaningful to his business.
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#96
#96
Oldvol75 said:
Why don't we have Obamacare for lawyers. Lets limit what they can charge and place standards over them where they have to serve anyone that comes into see them. Let lawers be government funded just like the doctors. If we do it one group, then why not another?
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yea, I've suggested a similar idea. Lawyers in favor
of all this government run healthcare nonsense don't
seem to muster up the same level of support for this.
 
#97
#97
Oldvol75 said:
Why don't we have Obamacare for lawyers. Lets limit what they can charge and place standards over them where they have to serve anyone that comes into see them. Let lawers be government funded just like the doctors. If we do it one group, then why not another?
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There is a qualitative difference between saying that people can represent themselves in court if need be versus perform open heart surgery on themselves.


BigPapaVol said:
Ask your GP about tort reform as meaningful to his business.
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Ask your GP what percentage of your insurance premium ends up paying for liability claims.

Like I said, I don't disagree that there should be some reforms in the tort system. I am just saying it wouldn't make that much difference.
 
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#98
#98
lawgator1 said:
There is a qualitative difference between saying that people can represent themselves in court if need be versus perform open heart surgery on themselves.
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You are right. You need top of the line healthcare providers because - by default - you have to put your life in their hands. In the legal profession, you can represent yourself if you can't find someone competent. Based on those differences, there seems to be less of a justification for a professional monopoly in the legal profession than there is in the healthcare profession.
 
#99
#99
lawgator1 said:
Tort reform is fine with me, but its really not nearly as significant a part of the cost of care as advertised by the business lobby.

Estimates vary but in particular there is evidence that much defensive medicine is driven by malpractice fears. We would likely see a drop in diagnostic testing costs (some estimates claim up to 1/3)

Mandated benefits would have some impact, but not as much as you might think. The ones that seem truly trivial are the least expensive.

Again the point is that the minimum baseline for coverage is unnaturally high due to these mandates. Drop them to pure health necessities (a major debate) and new lower cost policies can enter the market. Notably, employers that wish to offer insurance can choose from a broader range of plans or offer to support the low range plans for all employees

The poor cannot afford catastrophic care. And they wouldn't buy it anyway. If they don't, and get ill, what do you say to them? No care?

Not sure they wouldn't buy it anyway if it were more affordable - we are being told that people are uninsured because they cannot afford it and health bills bankrupt them. This could be subsidized and the poorest will remain on medicaid.

See, that's the problem. If all have access to care but only some pay for it, then those paying dwindle in number, by dropping out directly or by cost shifting their premiums to us.

I'm suggesting why more would pay for it if the range of options were larger. Currently, state and federal regulations prevent the range from being larger. It's like requiring anyone that wants a to buy a car choose from only new ones above 20K. What I'm suggesting will allow some to buy cheap, reliable used cars that provide basic transportation and others to buy all the way up to Maybachs. Doing this would expand the number of insured not reduce it. It would allow companies to have more flexibility in managing their healthcare costs and it would operate like true insurance.

We pay for it, one way or another. You have to enforce noncoverage decisions and no one is politically up to the task.
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What I'm suggesting will lower the cost of insuring in the short run. By re-exposing consumers to the real costs of HC choices, it should also reduce HC costs in the longrun as demand is tempered by market forces and supply shifts to try to capture that demand.

Unfortunately, Obama is going the opposite way. His plan will run well over $1 trillion and does nothing to drop the cost curve.
 
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#100
#100
lawgator1 said:
Ask your GP what percentage of your insurance premium ends up paying for liability claims.

Like I said, I don't disagree that there should be some reforms in the tort system. I am just saying it wouldn't make that much difference.
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You are missing the cost savings. Liability insurance is only a small fraction of the cost savings. The vast reduction in defensive medicine is where the cost savings come from. The CYA mode of ordering tests to prevent future law suits is a source of artifact demand for HC services.
 
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